Shiffman S, Dunbar MS, Tindle HA, Ferguson SG. Nondaily smokers' experience of craving on days they do not smoke. Journal of abnormal psychology. 2015 Aug;124(124). 648-59. PMID: 26052617 [PubMed] PMCID: PMC4624293 NIHMSID: NIHMS696483.
Nondaily, or intermittent smokers (ITS), represent a growing pattern in adult smoking that needs to be explained by models of drug dependence. ITS regularly and voluntarily abstain from smoking, yet have difficulty quitting. We examine potential accounts of ITS' smoking by exploring their experience of craving and withdrawal on the days they abstain. For 3 weeks, 146 ITS and 194 daily smokers used the Ecological Momentary Assessment (EMA) to monitor craving, withdrawal, and smoking in real-time. ITS' craving (p < .001) and arousal (p < .001) were significantly lower on the 34.4% of days when they abstained (compared with days they smoked), and they experienced no increases in withdrawal symptoms. ITS who abstained for longer experienced lower craving, even on their first day of abstinence (p < .001). Within strata defined by longest duration of abstinence (1, 2-3, 4-6, ≥7 days), craving did not change over time, demonstrating no increase as resumption of smoking approached. Craving increased only at the moment smoking resumed. Furthermore, duration of abstinence runs varied more within persons than across persons. These findings contradict the predictions of a model positing that craving recurs at fixed intervals. Findings are consistent with the hypothesis that ITS' smoking is cued or primed by particular stimuli rather than by temporal cycles. These analyses demonstrate that ITS do not experience increased craving or withdrawal on days they do not smoke, and show neither signs of classical dependence nor regular cycles of craving and smoking.